York: Ebola is a warning sign of a much bigger crisis

A frightening disease hit an African country this month, infecting thousands of people and killing dozens. Hospital wards were jammed, health workers struggled to cope. As cases soared, overwhelmed officials called the impact “staggering.”

But this outbreak didn’t provoke any global headlines, because it was just another cholera outbreak in Ghana – an almost annual event in the capital, Accra.

Ebola, of course, has captured the media’s attention: It has a much higher death rate than other diseases, and it has had a devastating effect on Liberia, Sierra Leone and Guinea. The world is right to send medical aid to those countries and to stay alert to suspected new cases.

But it’s also true that Ebola is less contagious than other diseases; it is transmitted by bodily fluids, not by air, water or mosquitoes. The virus has been spread by commercial airplane only once, by an ill passenger to Nigeria.

Other diseases, including malaria and diarrheal diseases such as cholera, routinely kill far more people than Ebola across Africa. In the Ghana outbreak alone, more than 3,100 people were infected and nearly 50 were killed. Even at the epicentre of the Ebola outbreak, malaria has caused up to 35 times more deaths than Ebola this year.

But Ebola is a warning sign of a much bigger crisis: the fragility of African health and sanitation systems after many years of poverty, illiteracy, neglect and, in some countries, catastrophic civil war. Even in countries that have recently seen impressive economic growth and foreign investment, the money is failing to reach the hospitals and health-care workers who can prevent disease outbreaks.

Government authority has been almost non-existent in many West African regions, including, crucially, the border crossings in the Ebola “hot zone” where a million people live. Hospitals and clinics, meanwhile, are severely under-staffed, suffer from shortages of equipment (even such basics as disposable rubber gloves) and medicine, and often lack even electricity and running water.

Everywhere the signs of state collapse have been exposed. Bodies of Ebola victims, often lie uncollected in homes and streets for days at a time. Some hospitals have been completely abandoned after staff and patients fled. Quarantine efforts sometimes fail because people simply walk around the checkpoints.

The spread of Ebola out from the villages of southern Guinea, the source of the current outbreak, was fuelled by a similar state failure. Guinea’s first cases were confirmed in March, and by April the virus was taking hold.

But the health system was so inadequate, and ignorance so widespread, that many people with the Ebola virus decided to cross over the poorly controlled border to Sierra Leone, where they sought treatment from a herbalist who claimed to have the power to cure Ebola.

Instead of curing others, she soon became infected with the Ebola virus and died. Mourners at her funeral then spread the disease across the region, according to published reports. The herbalist’s death led to hundreds of new cases of the disease in Sierra Leone.

Margaret Chan, director-general of the World Health Organization, says the Ebola outbreak has “allowed the world to see what can happen when a lethal and deadly dreaded virus takes root in a setting of extreme poverty and dysfunctional health systems.”

A frightening disease hit an African country this month, infecting thousands of people and killing dozens. Hospital wards were jammed, health workers struggled to cope. As cases soared, overwhelmed officials called the impact “staggering.”

But this outbreak didn’t provoke any global headlines, because it was just another cholera outbreak in Ghana – an almost annual event in the capital, Accra.

Ebola, of course, has captured the media’s attention: It has a much higher death rate than other diseases, and it has had a devastating effect on Liberia, Sierra Leone and Guinea. The world is right to send medical aid to those countries and to stay alert to suspected new cases.

But it’s also true that Ebola is less contagious than other diseases; it is transmitted by bodily fluids, not by air, water or mosquitoes. The virus has been spread by commercial airplane only once, by an ill passenger to Nigeria.

Other diseases, including malaria and diarrheal diseases such as cholera, routinely kill far more people than Ebola across Africa. In the Ghana outbreak alone, more than 3,100 people were infected and nearly 50 were killed. Even at the epicentre of the Ebola outbreak, malaria has caused up to 35 times more deaths than Ebola this year.

But Ebola is a warning sign of a much bigger crisis: the fragility of African health and sanitation systems after many years of poverty, illiteracy, neglect and, in some countries, catastrophic civil war. Even in countries that have recently seen impressive economic growth and foreign investment, the money is failing to reach the hospitals and health-care workers who can prevent disease outbreaks.

Government authority has been almost non-existent in many West African regions, including, crucially, the border crossings in the Ebola “hot zone” where a million people live. Hospitals and clinics, meanwhile, are severely under-staffed, suffer from shortages of equipment (even such basics as disposable rubber gloves) and medicine, and often lack even electricity and running water.

Everywhere the signs of state collapse have been exposed. Bodies of Ebola victims, often lie uncollected in homes and streets for days at a time. Some hospitals have been completely abandoned after staff and patients fled. Quarantine efforts sometimes fail because people simply walk around the checkpoints.

The spread of Ebola out from the villages of southern Guinea, the source of the current outbreak, was fuelled by a similar state failure. Guinea’s first cases were confirmed in March, and by April the virus was taking hold.

But the health system was so inadequate, and ignorance so widespread, that many people with the Ebola virus decided to cross over the poorly controlled border to Sierra Leone, where they sought treatment from a herbalist who claimed to have the power to cure Ebola.

Instead of curing others, she soon became infected with the Ebola virus and died. Mourners at her funeral then spread the disease across the region, according to published reports. The herbalist’s death led to hundreds of new cases of the disease in Sierra Leone.

Margaret Chan, director-general of the World Health Organization, says the Ebola outbreak has “allowed the world to see what can happen when a lethal and deadly dreaded virus takes root in a setting of extreme poverty and dysfunctional health systems.”